When Texas Went After Transgender Care, Part 2

[0] From the New York Times, I'm Michael Bobarro.

[1] This is a daily.

[2] Yesterday, in part one, my colleague, Azeen Gerasi, described the complicated medical questions that doctors and families are grappling with as more and more transgender teens are seeking care.

[3] My name is Grayson, and I'm currently 17.

[4] How about?

[5] I'm Holly.

[6] older than the hills.

[7] No, I'm 62.

[8] She introduced us to Holly and her son, Grayson, a trans teenager in Texas, who for many years had been struggling with questions around his identity.

[9] I remember vividly that, like, every single night I've come home so sad, I didn't know why, and then I'd just start to cry when I got to my room, and I'd cry because I was lying to everyone in my life.

[10] and had recently begun to medically transition at the only clinic of its kind in the state, Genesis.

[11] How did you feel the moment you heard about Genesis?

[12] I had up to that point not known that it had existed, so it was like a light bulb went off.

[13] I was like, oh, this is my chance.

[14] Today, our colleague, David Goodman, picked.

[15] up with the story of another family who was considering bringing their child to that clinic and how that family helped touch off one of the most heated political battles in the country.

[16] It's Thursday, April 21st.

[17] David, I think most people at this point are aware of the political battle that is playing out in Texas right now, led by the state's governor, Greg Abbott, around the care being provided to young trans people.

[18] But I suspect not that many people have heard the story of where this all began.

[19] And that's the story that you have spent a lot of time recently reporting.

[20] So tell us about that.

[21] Well, so a couple of years ago, around 2017, 2018, there were these two parents in the suburbs of Dallas, and Georgoulis and Jeff Younger.

[22] And they're in the middle of a divorce, a very contentious divorce.

[23] And during this period, one of their young kids starts to identify as a girl, which was not the sex she was assigned at birth.

[24] And she starts to go by the name Luna.

[25] Now, Anne, Luna's mother is a pediatrician, and she wants to follow their doctor's advice and affirm her gender identity.

[26] And so that means supporting Luna in her social transition, which means sort of embracing Luna as her name, letting her express gender as she wishes, which is, you know, growing her hair out or wearing dresses if she wants.

[27] and Anne, the mother, eventually planned to take her to Genesis to get medical care if that's the direction that Luna wanted to go.

[28] But Luna's father, Jeff, is entirely opposed to this approach and repeatedly tells people teachers and doctors and other family members to stop referring to her as Luna, and he uses her birth name.

[29] He also at one point shows up at Luna's elementary school and insists on changing her out of the clothes she's wearing it into boys' clothes, has an altercation with teachers and staff there over the approach that they're taking.

[30] And so as the divorce progresses, Luna's care becomes a central part of a really nasty custody battle.

[31] And as this custody battle heats up, Jeff Younger decides to take his family's story public.

[32] And what does that look like for Jeff Younger to take this story public?

[33] He does this in a variety of ways.

[34] He starts a website using the given birth name of Luna.

[35] He begins doing media interviews with right -wing outlets, some that are online, some that are publications that are a little more well -known.

[36] My name is Jeff Younger.

[37] I'm the father of two boys.

[38] And in these conversations, he really rejects Luna's identification as a girl.

[39] So I'm a red -blooded Texan.

[40] And I want you to imagine having electronic communication with your son on FaceTime.

[41] And imagine that your ex -wife has a drive -to -ex -ex -exam.

[42] arrest him as a drag queen to talk to you.

[43] He's really presenting himself as a parent who's being forced to go along, he would say, with a kind of movement on the left that has one view of his child that he doesn't hold.

[44] I believe this is not just emotional abuse, but is the very most fundamental form of sexual abuse, tampering with the sexual identity of a vulnerable boy.

[45] And he begins attracting the attention that he's seeking in large part because he really is this kind of folk hero, a sort of perfect encapsulation of a lot of the points about parents' rights that the right is focused on at this point in the battle over trans rights.

[46] You know, and he's willing and interested in being interviewed and being out there, which is very helpful for that cause.

[47] But then something important happens in the custody battle.

[48] a jury decides against him and finds in favor of Anne and grants her custody of the kids, which means essentially that she can continue on the path of transition for Luna and that Jeff has essentially lost control over his child.

[49] Ladies and gentlemen, we are in a war with the left.

[50] And that really draws a new order of attention to the case.

[51] If they win on this issue, We lose the movement.

[52] That's pretty disturbing stuff.

[53] Mommy should not be telling a boy that he is a girl, that is child abuse.

[54] It is.

[55] We need to go on the offensive and put this woman behind bars for child sex abuse.

[56] And it draws outcry from, you know, top Republicans like Senator Ted Cruz and Governor Greg Abbott in Texas.

[57] Last night, Texas Governor Greg Abbott said the State Attorney General and Department of Family and Protective Services will look into that case.

[58] days after the jury made its decision, a judge vacated its grant of custody to Anne.

[59] And so at this point, where we are now, the question of which parent will decide on any medical treatment for Luna, that's actually still up in the air.

[60] But in the meantime, on the right, the narrative is very simple and animating, and it continues, that they must find ways to protect parents and kids from all of those.

[61] And so by 2021, what you have is political momentum that has been building for the last a couple of years before, it really sort of springs forth, and we see a wave of bills being introduced in dozens of state houses.

[62] Transgender people are the target of legislation across the country.

[63] Republican -controlled state houses around the country.

[64] Republican governors in South Dakota, Tennessee, Mississippi, and Arkansas.

[65] Lawmakers in 28 states are considering 93 bills targeting the rights of transgender Americans.

[66] And most of them are aimed at trans youth.

[67] And what they're doing is taking a kind of two -pronged approach.

[68] Now, recently, more than two dozen states have either passed or about to pass legislation, which limits transgender athletes to only playing in the gender they were born.

[69] They're both looking at preventing trans youth from playing on sports teams that align with their gender identity.

[70] And then there's other bills that target gender -affirming care for trans youth.

[71] In Alabama, there's a bill that would make it a felony punishable by up to 10 years in prison for a doctor to prescribe gender -affirming medication.

[72] for trans people under age 18.

[73] Now, Republican lawmakers in Texas tried to pass both kinds of bills.

[74] And when they tried to pass a bill banning gender -affirming care, the lawmakers wanted to hear from a person who had become the most famous, really, spokesperson on the issue, Jeff Younger.

[75] Very good.

[76] Thanks, Senator, we'll call the invited testimony and the chair calls Jeff Younger.

[77] And so they bring him into testify.

[78] My name is Jeff Younger.

[79] And he tells this now familiar story of his family, once again referring to his child as his son.

[80] A young Texan, who was very nearly chemically castrated.

[81] And he describes the care that his child would have received in this really gruesome and sort of over -the -top way.

[82] And very nearly put on cross -sex hormones where he would have been permanently sterilized, and his skeleton would have been irreversibly harmed.

[83] And in his testimony, he brings up by name, the clinic that his ex -wife Anne had hoped eventually to bring Luna to for care.

[84] The Genesis Clinic is a clinic in Children's Hospital.

[85] It provides what it calls gender affirmative care, and they refer out children for surgeries where their genitals are mutilated in transgender sex change operations.

[86] But in the end...

[87] Any of the questions from Mr. Younger at this point?

[88] Democrats, anybody?

[89] I'd love to have questions from...

[90] We'll...

[91] Okay.

[92] you're excused and we'll have you back for Senator Barrier's bill.

[93] Thank you for your testimony.

[94] Ultimately, not enough Texas lawmakers were willing to vote for these bills on gender affirming care and so they fail and the legislative session comes to an end, but the energy around this issue does not go away and the far -right Texas Republicans they're seeing other states take action and they're saying to themselves we need to do something and we didn't do anything.

[95] And so this pressure is still there on Governor Abbott to take action on this issue.

[96] And that leaves Governor Abbott in a tricky position because he's a Republican, and he's up for re -election in 2022, and he's also got this primary challenge from the right of his party.

[97] And it's the first one that he's really faced like this in his career.

[98] And - Session underway, Governor Greg Abbott is with us.

[99] This is a clear vulnerability for him.

[100] He's being pushed on this issue.

[101] Why, in a conservative state with Republicans in charge, a law that says, we're not going to let you carve up your 10th grader because he thinks he's a girl.

[102] how in God's name does that not pass in Texas?

[103] And during a radio interview, I can't answer for that other than I can gain the odds.

[104] However, what I can tell you is I have another way of achieving the exact same thing.

[105] Abbott assures conservatives that he hears them loud and clear and that he does have a plan.

[106] It may be announced as soon as this week.

[107] So, I will respect your timing on that and just ask one more thing that when that solution does make itself.

[108] own, will the end result, if as you said, the bottom line is what matters, is that crazy parents and crazy doctors will not be able to try to turn girls into boys and vice versa in the state of Texas?

[109] Yes.

[110] Okay.

[111] And with only one clinic in the state that's focused on this kind of care, it's not hard to see where Governor Abbott might be headed.

[112] After the break, Azeen returns with the story of how that played out.

[113] We'll be right back.

[114] So Azeen, we have just heard the story of how it is that Governor Abbott ends up focused on this care being provided to young trans people.

[115] And I'm wondering how this is being experienced by Holly and Grayson, who, is now about a year into his treatments at Genesis.

[116] Yeah, so naturally, Holly and Grayson have been paying really close attention to what's going on in the Texas State House and to the comments that Governor Abbott has been making.

[117] Were you guys ever worried about Genesis?

[118] Yes, almost immediately after I heard about all these bills, I was like, I wonder what's going on with them.

[119] I don't know what's going to happen.

[120] Yes, absolutely, absolutely.

[121] fact, when the bills, well, the majority of the bills never made it through the legislature in time to be signed.

[122] So I was grateful for that.

[123] But I anticipated and predicted and unfortunately had been vindicated in that prediction that politicians, because there were hints of it on the radio by our governor, that there's more than one way to skin a cat.

[124] So what Holly means by that is that it seemed pretty obvious from what Abbott was saying.

[125] that he intended to actually do something about it, whether or not Republicans were able to get these bills passed.

[126] And it wasn't long after that that I got a tip that showed how it was that Abbott was starting to do that.

[127] And how was he starting to do that?

[128] Okay.

[129] So remember, Genesis is housed in a children's hospital in Dallas, but it's actually run by the University of Texas Southwestern Medical Center.

[130] Right.

[131] So it's part of a state.

[132] school, meaning it's technically under the purview of Governor Abbott.

[133] And so I got access to these secret recordings of conversations between hospital executives from around this time.

[134] Okay, well, they are here and I'm here, so we both got on a couple minutes early.

[135] In these recordings, what you hear is the executives talking about the pressure they are under to shut down Genesis.

[136] And some of that pressure, they say, is coming directly from.

[137] the governor's office.

[138] So we received a reach from the governor also requesting information about the clinic.

[139] And I will say this, I do not think in our current circumstances, without some modification of the clinic, that it would be allowed to continue.

[140] I think people will come after it until it's gone.

[141] One of these executives says, look, I don't think this is going to end until we shut down the clinic.

[142] And as a state agency, you know, we have to follow the direction of elected officials and certainly of the governor's office, et cetera.

[143] So let me stop there.

[144] So executives at the university are pretty quickly indicating that as a state -run institution, they think that the best thing to do here is go along with what it's become clear to them is what Governor Abbott wants, which is.

[145] to get rid of Genesis.

[146] That's right.

[147] And around November, word of this does start to get out.

[148] Some doctors are hearing about this and voicing concern.

[149] They're talking about how this is the only clinic in the state that provides this kind of care and how, therefore, they feel an ethical responsibility to provide this care to patients who need it.

[150] And even families at the clinic, like Holly and Grayson, start to hear that the clinic might be in trouble.

[151] I heard about, like, the potential for it to shut down first.

[152] And I was like, oh, there's no way.

[153] Like, I was like, they can't, they wouldn't do that because there's so many people that they're treating all over Texas who come and see them like every year.

[154] How could they conceive of doing this?

[155] And then all of a sudden...

[156] It started with, like, them taking the website page down.

[157] And I was like, oh, that can't be good.

[158] The hospital shuts down the clinic's website.

[159] And I was like, maybe it's.

[160] just technical difficulties.

[161] But it's actually the hospital shutting down the clinic, with no explanation to the staff or to the patients getting care there.

[162] I was like, how will this affect me?

[163] Do I still get treatment?

[164] Am I just like left hanging out to dry?

[165] Or like, what's the direction?

[166] And what does the government expect all these people to do once they strip them off their health care?

[167] Hmm.

[168] And so what are the answers to these questions?

[169] So like a week after the website was taken down, the hospital tells the clinic, look, you can keep providing care to your existing patients for now, but you can't take on any new patients.

[170] So this is the last round of patients that will be seen in Genesis.

[171] Right.

[172] But Governor Abbott isn't done.

[173] This past February just days.

[174] before the Republican primary for governor in Texas.

[175] Texas Governor Greg Abbott is ordering people in his state to investigate gender -affirming care for transgender children as child abuse.

[176] He issues a letter backed by the state's Attorney General.

[177] The governor citing treatments like reassignment surgery, hormones, and puberty -blocking drugs, which Attorney General Ken Paxton argues are illegal under Texas law.

[178] This letter is kind of extraordinary.

[179] It directs the state's child.

[180] Child Welfare Agency to investigate the kind of gender affirming care provided at Genesis, the kind of care Grayson is getting as child abuse.

[181] The same phrase that Jeff Younger used in his early interviews.

[182] Yeah.

[183] And, you know, we haven't really seen this in the other states that have introduced bills yet.

[184] This is really a first, and it set off the alarms right away.

[185] These kids, they see this.

[186] They're aware of what's...

[187] happening.

[188] And they're being told that because of who you are, you might get taken away for your parents and your parents might go to jail.

[189] How is a kid supposed to react to that?

[190] It is despicable.

[191] And anyone who believes that parents should love and respect and empower their children to be happy, successful kids should be concerned by the fact that the governor of Texas believes he knows better than parents on how to treat their children.

[192] So under the term, of this letter, anyone who interacts with any of these kids, so that's doctors, counselors, therapists, teachers, anyone who finds out that a kid is getting gender affirming care has to report them to the state.

[193] Wow.

[194] And this is for making decisions that the parents are making with their kids and their doctors, and suddenly that is being labeled child abuse in the state and could be grounds to actually separate the kid from their parents.

[195] So this, again, is Governor Abbott going around the legislative process, right, just as he seems to have done, according to your reporting, in exerting pressure on Genesis.

[196] In this case, he just issued a directive instructing the Texas Department of Family and Protective Services that they are to treat this care as child abuse.

[197] Right.

[198] And basically right away, this got challenged in court.

[199] The agencies started to investigate a few.

[200] families.

[201] One of those families sued.

[202] And for the past month, the directive has been temporarily blocked by state courts with a big trial date set for July.

[203] But I've talked to a lot of families in the state, not just Holly and Grayson.

[204] And they say that even with this order temporarily blocked, you know, they're terrified.

[205] You know, they live in a state where their governor has instructed people to report them to the government.

[206] I have to, I have to.

[207] I have to check myself in conversation now about whether or not I'm, like, alone or I'm talking with someone that I trust, because I'm honestly not sure anymore.

[208] I mean, some kid at school that get pissed off at Grayson, because Grayson might have accidentally cut him off in the parking lot, could call CPS.

[209] You just don't know.

[210] You have no idea.

[211] My neighbors could.

[212] I mean, anybody could.

[213] Anybody could.

[214] told me about a recent experience she and Grayson had.

[215] Just this past weekend, actually, Grayson had an abscess on his chin.

[216] And I did a video appointment, and then the video guy said, no, you have to take him to an urgent care.

[217] And, you know, I called my ex and I'm like, I'm nervous, you know.

[218] He's got to be seen if this is an infection and it's spreading.

[219] The kid has to be seen medically, but, you know, I'm walking into.

[220] into a clinic full of mandated reporters.

[221] So it's frightening, but, you know, I'd rather have a legal battle than a dead child or an infected child.

[222] So we went to the urgent care, and it was very scary to go.

[223] And I know a lot of other parents are going through the same thing.

[224] You're afraid to get your child any medical care because you're putting them in front of a mandated reporter.

[225] And it's frightening.

[226] It sounds weird to say hearing a story like that, but in some ways, Holly and Grayson are actually pretty lucky in this moment.

[227] Like, as of right now, they are continuing to provide the medication that my son is on.

[228] Grayson can still go to Genesis, at least for now.

[229] And even if that changes, they do have options.

[230] If that stops, we're not going to discontinue treatment.

[231] we'll go elsewhere to get it.

[232] We're fortunate.

[233] We have the resources to do that.

[234] Who this hits disproportionately is, you know, minorities and people of lesser financial abilities than I actually have.

[235] That's who's going to bear the brunt of it.

[236] They can't afford to move out of state.

[237] They can't go elsewhere.

[238] And then there are the kids who weren't already receiving care at Genesis, who have way fewer options now that the clinic isn't taking new patients.

[239] This is a really tenuous moment for a lot of young people in Texas.

[240] And the stakes feel really high.

[241] So as the politics around this continue to escalate, there's this worry that I've seen emerge among people who are supportive of trans rights that voicing any questions or reservations in this moment about this medical care, like the questions Holly had when Grayson first came out to her, that that would be a betrayal and could somehow be used as a political weapon against the kids caught in the middle of this.

[242] I'm mindful that, like, in this moment of, like, so many bad faith arguments about what gender affirming care is, it sort of makes the actual hard decisions that parents are making, like, harder to talk about in a way.

[243] Very much so.

[244] Right.

[245] And, I mean, I even wonder, like, how does it feel talking to me or even voicing sort of the, any of the doubts or concerns that you had right when you were about to start treatment?

[246] Like, does it feel scary even acknowledging that some of those?

[247] Yes.

[248] Yeah.

[249] Yes, but, I mean, it wouldn't be realistic for me to say, I was all, I mean, it wouldn't be honest to say, you know, yeah, we were on board immediately and let's go and let's do this.

[250] It's a very thoughtful, careful decision that you make as a parent with medical care for your child, any kind of medical care, right?

[251] I mean, it's something a parent normally takes, I hope, very seriously.

[252] So I think if you don't have any doubts, you're not taking your job very seriously as a parent.

[253] You have to think of all sides.

[254] And maybe it's my educational background and training.

[255] But I really try to think of all sides of everything before I make any decision, especially one involving my child what are the pros what are the cons you know what are the benefits what are the burdens what could happen as as an attorney i'm trained to think about the worst possible case and guard against it on behalf of clients so i started to do that for myself too what's the worst that could happen and how do i mitigate that risk so it's it's the same kind of thought process so i think doubts are part of the process is it scary to talk about about the doubts just given how weaponized everything has become in the political conversation?

[256] Yes, yes, but I also think people need to realize that this is not a decision made lightly.

[257] I mean, I hope that would make it less polarized if people actually realize that I'm just behaving as any parent would with respect to any medical decision.

[258] I'm not I'm not doing this to foster some political agenda you know some of the baseless arguments about parents you know doing this willy -nilly on their kids is just crazy so I think it is important to let people know that it's not a decision that a parent is going to take lightly I just can't imagine that.

[259] I just can't.

[260] So it's frightening, but in a way, I hope it educates people that parents do this because they think it's in the best interest of their children, knowing that it may be a very hard path for them, but you have to do hard things sometimes.

[261] And I hope that being honest about the fact that I thought of it.

[262] about it a lot will help people understand that it shouldn't be a polarizing conversation.

[263] It should be something a parent gets to decide.

[264] It's not for a politician to decide.

[265] It's not for a legislature to decide.

[266] It's the quintessential sort of parental decision on behalf of a child.

[267] It's interesting because Holly is making an argument here that many conservatives would not only agree with, but that has become central to the Republican Party in this moment, which is the idea of parental rights, that parents should be able to make decisions on behalf of their own children.

[268] And that is something about this whole battle that has struck me as inherently contradictory, that a conservative, like Abbott, would be leading a political fight that is going directly after parents for making the decisions that they feel are right for their children.

[269] It's so at odds with so much of what conservatism claims to be about at this moment.

[270] Yeah, and I think there's a general sense, even in the conservative world, that Abbott may have overstepped here.

[271] You know, already we're seeing signs that he may let go, of the direct attack on parents and instead stay focused on the providers and pharmaceutical companies and other sorts of medical figures involved in providing gender affirming care, which is where most other Republican states have focused their laws and efforts on this front so far.

[272] So focus less on the parents, stay focused on the providers on things like shutting down a clinic like Genesis.

[273] Right.

[274] And now, obviously, the situation in Texas has become really extreme, and it's the most polarized version of what we're seeing happening around the country right now.

[275] Right.

[276] But even more moderate Republicans would tell you that they're glad this fight is happening because what they would tell you is that actually they are the ones looking out for young people, that this is all still quite new, that there's not enough data or scientific understanding yet, and if they don't question this type of care, no one will.

[277] that there's not enough candid conversation happening about all of this on the left.

[278] And so they're the ones these Republicans would say who are trying to do what's best for young people.

[279] And is there a point there?

[280] Well, it's interesting.

[281] You know, some of the doctors that they're going after, some of the doctors I talk to, would very much agree that there are still big pressing questions in this field.

[282] like why the numbers of young people identifying as trans are increasing so much, you know, how much mental health screening should happen before a teen is offered treatment.

[283] But they say that the best way to do this, the best way to start to answer these questions, is to continue collecting good data, especially on how these kids fare into adulthood, which happened to be what Genesis did for its patients.

[284] And as one scientist told me, that data is something that everyone on all sides of this issue wants.

[285] Right.

[286] So you close down a clinic like Genesis, you make it harder to get the answers.

[287] Right.

[288] And, you know, there are other approaches the Republicans could be taking here.

[289] In Europe, for example, we're now seeing some governments starting to say, hey, let's slow down a little, let's limit the number of kids we treat to those who need it the most, run rigorous clinical trials, look at the data, standardize our approach to this.

[290] And in the meantime, make sure kids are getting all the other services like mental health support that they could also benefit from.

[291] So, you know, Republicans could be trying to do things like that, slow things down, put more guardrails around care, make sure scientists are collecting as much data as possible.

[292] But that's not what they're doing.

[293] And so what every clinician actually caring for these kids has told me, is that Republicans are making a bad faith argument here, that they're not looking out for young people because ultimately, putting a stop to this kind of care doesn't get us any closer to answering the questions we desperately need answers to.

[294] And it absolutely guarantees that kids who need help navigating these questions have nowhere to go.

[295] Azeen, thank you very much.

[296] We appreciate it.

[297] Thank you.

[298] On Wednesday, Florida became the latest Republican -led state to try to restrict gender -affirming care.

[299] In a set of new guidelines, the state's Department of Health said that children under the age of 18 who identify as transgender should not be offered the option of either a social or medical transition.

[300] In justifying the guidelines, the Health Department cited what it said was a lack of sufficient data, about trans care, and the potential for, quote, long -term irreversible effects.

[301] We'll be right back.

[302] Here's what else you need to Notre Day.

[303] On Wednesday, in his latest push a inter -continental ballistic rocket from.

[304] On Wednesday, in his latest military provocation, Russian President Vladimir Putin said he had successfully test -launched a new form of intercontinental ballistic missile that could deploy nuclear warheads at hypersonic speeds anywhere in the world and evade all existing defenses.

[305] In televised remarks, Houdin said that the launch was a warning to Western countries that they should think twice before threat.

[306] Russia, a clear reference to nations, including the U .S., that are providing military aid to Ukraine.

[307] But the Times reports that it does not appear that the missile technology is truly ready for use.

[308] Today's episode was produced by Sydney Harper, Chelsea Daniel, Rachel Quester, Rob Zipko, and Eric Krubke.

[309] It was edited by Lisa Tovin and Lisa Chow.

[310] Contains original music by Marion Lazzano and Alicia E. Tube.

[311] And was engineered by Chris Wood.

[312] Our theme music is by Jim Brunberg and Ben Landfirk of Wonderly.

[313] Special thanks to Maddie Masiello.

[314] That's it for the Daily.

[315] I'm Michael Bobaro.

[316] See tomorrow.